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Biomedical subjects

M Wienbeck

Publications and source records attributed to M Wienbeck.

At least 217 records · Page 12Linked to original sources

[Effect of phenylalanine-vasopressin on the lower esophageal sphincter. Possible implications in the treatment of bleeding esophageal varices].

Vasopressin and its analogs are used inthe treatment of bleeding esophageal varices. Since gastrointestinal reflux may have a deleterious effect on variceal hemorrhage, the effect of 2,3-phenylalanine-8-lysine-vasopressin upon the lower esophageal sphincter (LES) was studies by rapid pull-through manometry in 24 persons. PLV infusion up to a dosis of 2.7 mU/kg/h raised LES pressure from 15.1 +/- 1.3 (SEM) to 17.9 +/- 2.0 mm Hg. Higher doses lowered LES pressure progressively to 12.1 +/- 0.7 mmHg at 54 mU/kg/h. The serum gastrin level did neither correlate with basal LES pressure not with LES pressure changes during PLV infusion. Therefore, PLV does not appear to act indirectly through serum gastrin. Because of the danger of systemic side effects and of the undesirable in LES pressure with the usual high doses of vasoactive substances, a continuous infusion of lower doses of vasopressin analogs appears to be advantageous.

Adult↗

[Benign diseases of the esophagus. An internist's view].

The work-up of patients with benign diseases of the esophagus should start with a diagnostic evaluation. This includes a carefully taken history, radiologic and endoscopic examinations and, in suspected reflux disease, recording of intraesophageal pH. For the evaluation of functional troubles esophageal manometry is recommended. Patients with complicated reflux disease and failures of antireflux treatment should be operated upon. In high peptic stenoses, Barrett's syndrome should be carefully looked for. Achalasia is treated by pneumatic dilatations with more than 90% good or satisfactory results. But diffuse esophageal spasm is little responsive to therapy. There is a risk of secondary carcinoma in Barrett's syndrome, achalasia, caustic lesions and Plummer-Vinson syndrome. Therefore these patients should be seen at regular intervals. There is an urgent need for controlled studies evaluating the comparative results of medical and surgical therapy.

Diagnosis, Differential↗